Fever in children must be lowered only when the child suffers from it

Dr. Darko Stamenov

If the temperature rises sharply, then this often helps against pathogens. Whereas it is not necessary to reduce fever in children as long as the child does not suffer from it!

It is generally a misconception that fever must be brought down immediately. Especially Fever in children occurs frequently, but is rarely a dangerous symptom of the disease. Basically, fever is not a disease, but an active reaction of the organism to invading pathogens. In order to fight these and thus heal the body itself. As long as fever in children does not lead to noticeable discomfort, a higher temperature does not have to be lowered under all circumstances.

How dangerous, how useful fever is

In recent decades, physicians as well as family doctors and pediatricians have come to appreciate more and more the healing effect of fever in children in the fight against bacteria and viruses. Fever in children – but also in healthy adults – activates the body’s immune system; fever in children is particularly effective against viral infections.

A rectal reading should last at least five minutes, and under the armpit or tongue at least ten minutes. Fever in children should ideally be measured with digital clinical thermometer.

This is because the multiplication of numerous viruses is significantly slowed down at temperatures above 38.5 degrees. Since children are still susceptible to many viruses against which adults have long since developed immunity, the body uses fever in children as a defense very frequently.

It is not necessary to reduce fever in children as long as the general condition is good

As long as children do not feel too ill and make a good general impression in other respects, there is no need to initiate measures against fever in children to lower the temperature. Experts therefore recommend that no steps need to be taken to reduce a fever in children who are lively and eat and drink normally despite an elevated temperature.

However, if the temperature rises above 38.5 degrees, a child’s general condition may soon deteriorate. Muscle and limb pain may set in, loss of appetite and general malaise may occur. As soon as the child is obviously suffering, steps should be taken immediately to reduce the fever.

Readings on the thermometer not decisive

Fever in children does not make them sick. It is the pathogen behind the infection or inflammation that is responsible for the onset of the disease. It is therefore significant to discover the cause of the fever. Fever in children is therefore an accompanying symptom of an incipient illness that needs to be treated.

Several studies have shown that fever is one of the most important immune reactions of the body. Furthermore, it has been proven that the growth of viruses as well as some bacteria is strongly inhibited by increased temperature.

Fever in children as a useful reaction of the organism against invading pathogens run best at a fever condition between 39 and 40 degrees. The so-called scavenger cells – phagocytes – can fight bacteria optimally at a temperature of 39 degrees.

High fever in children at a younger age is less problematic

Small children can tolerate high temperatures in principle better than adolescents or adults. Even high fever above 40 degrees often do nothing from. But again, if the child is suffering from the fever, is restless and crotchety, refuses to drink and eat, cannot sleep, is confused, or if he or she has ever had a febrile seizure, the countermeasures should be taken.

How best to measure fever in children

Nowadays there are many innovative, modern digital thermometers. They are faster than the old mercury thermometers and, moreover, do not contain dangerous mercury. Suitable are also electronic ear and forehead thermometers. However, inaccuracies are possible with them (for example, due to earwax).

When using an old mercury thermometer, the fever in children should always be measured "rectally", i.e. in the buttocks. This is especially true for smaller children. When measuring in the mouth there is a risk of injury by biting the thermometer, in the armpit the measurement is too inaccurate. When taking the temperature in the anus, the thermometer must be held firmly and the child must not be left to his or her own devices. The measurement should be taken rectally for at least five minutes, and under the armpit or tongue for ten minutes.

However, the old mercury thermometers are used less and less, and damaged ones do not belong in household waste.


Suppositories are the ideal form of medication for small children, because they do not have to swallow them. Suppositories usually contain the analgesic and antipyretic substance paracetamol. It is important to follow dosage instructions exactly because acetaminophen can cause severe liver damage in overdoses.

Equivalent to paracetamol, fever in children can be treated with ibuprofen. Namely, the agent is also suitable for the simultaneous relief of pain. Further, ibuprofen has proven effective in the treatment of middle ear infections – otitis media.

Acetylsalicylic acid (ASA, "aspirin"), should not be used under any circumstances in children under twelve years of age because of the very rare but dangerous risk of "Reye’s syndrome" (with the risk of severe liver and brain damage). Some pediatricians prescribe "Viburcol" suppositories. They contain active ingredients of chamomile and relieve the child the annoying accompanying symptoms of fever such as restlessness, headache and insomnia.

Home remedies for fever in children

children with fever need a lot of fluids, to replace the water lost through perspiration. As long as the Child shivering at the beginning of the rise in fever, parents should Provide for warming. And it is best to do this with a woolen blanket or a hot water bottle.

Cooling measures should be done only when not only the face and forehead are already very warm. But this should be done only when also the legs and the rest of the body of the child already warm feel.

Classic home remedies to reduce fever in children include the following Calf wrap. They do not have to be cold. A temperature difference of about ten degrees is sufficient. If you use warm water (22 degrees) or even up to 30 degrees, you avoid unnecessary frightening of the child.

When swaddling, parents should always wrap both calves separately. Wipes should reach from the ankles to just below the knees. Renew wraps every five to 15 minutes until fever is down one to two degrees.

Important restriction: Calf wraps are only useful if the legs and also the rest of the body are warm. In case of cold limbs one should not use the calf wraps in any case.

Reduce the fever with a cooling bath

Most children like to bathe, so they find a fever-reducing cooling bath pleasant. At the beginning, the temperature of the bath water is about two degrees Celsius above the body temperature. Then run cold water – so that the water temperature drops to about 30 degrees within ten minutes. The small patient should remain in the cooled water for about seven minutes. Washing the naked child with lukewarm or cool water is also considered pleasant by many children.

Some naturopathic doctors recommend reducing fever in children with enemas containing chamomile.

Fever in children: special warning signs

– The Fever exists for more than three days.

– The Child refuses the Drinking, loses fluids and dries out.

– The child is fine. But the Vomiting lasts longer than twelve hours (if the child is not well, earlier to the doctor!).

– The child is fine, but the diarrhea lasts longer than two days. And if the child is not well, you should definitely go to the doctor sooner!.

– The child has severe abdominal pain or cramps.

– The Pain become despite treatment more strongly.

– That Child cramps.

– The child has a Rash or shows symptoms like pain of the Ears as well as discomfort with breathing.


Basically, illnesses with fever are also among the most common causes of a child’s hospital admission. Most cases are viral in origin and as reported usually have a good prognosis.

Fever can also indicate a severe, rapidly progressing illness. Parents as well as doctors and caregivers have respect for this, which can lead to "fever phobia" and inappropriate therapy of minor illnesses.

Pediatricians and family doctors in particular are called upon to assess the situation correctly. You need to reassure agitated parents and give them plausible information about the fever and the appropriate use of medications and home remedies. Finally, families must also be very careful that the child does not become dehydrated.


Paul SP, Kini PK, Tibrewal SR, Heaton PA. NICE guideline review: fever in under 5s: assessment and initial management (NG143). Arch Dis Child Educ Pract Ed. 2021 Jul 9:edpract-2021-321718. doi: 10.1136/archdischild-2021-321718. Epub ahead of print. PMID: 34244233.

Stanway D. Fever in children. Nurs Stand. 2015 Feb 27;29(26):51. doi: 10.7748/ns.29.26.51.s45. PMID: 25711594.

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